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Hepatitis C-Related Liver Disease Now a Major Cause of Death Among HIV-Positive Individuals

Hepatitis C-related liver disease has become a "major cause of death" among
HIV-positive individuals, according to a report in the Feb. 1 issue of Clinical Infectious Diseases, Reuters Health reports. Dr. Barbara McGovern of the Boston, Mass.-based New England Medical Center and colleagues examined the incidence of fatal liver disease among HIV-positive patients at the hospital between 1991 and 1999. In 1991, before the introduction of combination antiretroviral therapy, liver disease was responsible for 11.5% of deaths among HIV patients. In 1996, shortly after the introduction of the drugs, about 14% of HIV patients died of liver disease. However, between 1998 and 1999 half of
HIV-related deaths were associated with liver disease. The researchers speculate that most of the patients contracted hepatitis C, as well as HIV, through
injection drug use. "End-stage liver disease has become the leading cause of death of HIV-seropositive patients at our institution," McGovern concluded, adding that hepatitis C may be taking a "more deadly toll" on HIV-positive patients because death rates from other AIDS-related illnesses are falling. Hepatitis C is spread through blood or sexual contact and can remain latent for "years, even decades." Drug therapy can suppress hepatitis C, but there is no cure for liver damage caused by the disease. The researchers recommended that doctors be "more vigilant in testing and treating HIV patients suspected of having hepatitis C" and suggested adding hepatitis screening to the tests routinely done on an initial visit after a patient tests positive for HIV infection (Boggs, Reuters Health, 2/19).
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